安徽省广德县山区易感动物无形体检测结果分析

目的了解安徽省广德县鼠、狗、羊中自然感染埃立克体及无形体的状况。方法用巢式PCR扩增鼠、狗、羊血块中埃立克体属及无形体属16SrRNA5’末端片段,用嗜吞噬细胞无形体与嗜单核细胞埃立克体种特异引物扩增阳性产物做测序分析。结果在安徽省广德县捕捉的5只鼠、11只狗、10只羊,用标本血块做核酸检测,其中鼠阳性0份,狗阳性0份,羊阳性4份,阳性率40％,将属特异性引物扩增产物做测序分析。于Genbank上做比对分析,4份均与牛株无形体相同基因区最为接近,属无形体科,无形体属。结论安徽省广德县存在无形体病原,羊可能为无形体宿主,其他宿主需进一步调查研究。     

安徽省广德县山区易感动物无形体检测结果分析

目的了解安徽省广德县鼠、狗、羊中自然感染埃立克体及无形体的状况。方法用巢式PCR扩增鼠、狗、羊血块中埃立克体属及无形体属16SrRNA5’末端片段,用嗜吞噬细胞无形体与嗜单核细胞埃立克体种特异引物扩增阳性产物做测序分析。结果在安徽省广德县捕捉的5只鼠、11只狗、10只羊,用标本血块做核酸检测,其中鼠阳性0份,狗阳性0份,羊阳性4份,阳性率40%,将属特异性引物扩增产物做测序分析。于Genbank上做比对分析,4份均与牛株无形体相同基因区最为接近,属无形体科,无形体属。结论安徽省广德县存在无形体病原,羊可能为无形体宿主,其他宿主需进一步调查研究。     

金东区鼠类检出埃立克体及无形体DNA片段

目的 了解金华市金东区某地鼠类自然感染埃立克体及无形体的状况。方法 对当地监测捕获的多种鼠类取肝、脾脏器标本，用巢式PCR扩增无形体科16S rDNA的5’端片段。结果 在184只鼠中，检出阳性6只，总阳性率为3．26％；其中黄毛鼠阳性率为4．12％（4／97），社鼠阳性率为4．17％（1／24），黑线姬鼠阳性率为4．35％（1／23）。经序列比对分析，4份与牛埃立克体相应片段最为接近，属无形体科，无形体属；1份与反刍动物埃立克体相应片段区最为接近，属无形体科，埃立克体属；1份与无形科新成员Ehrlichiasp．‘Ratusswain＇最为接近。结论 在当地鼠类检出埃立克体及无形体DNA片段，提示可能存在埃立克体病自然瘦源地。     

一组长角血蜱中检出莱姆病螺旋体和斑点热群立克次体复合感染

目的 了解浙江省山区野生动物和蜱中莱姆病、斑点热、埃立克体病(无形体病)的感染情况.方法 采用巢式PCR对采集的鼠、蜱标本进行莱姆病伯氏疏螺旋体、斑点热群立克次体、埃立克体(无形体)特异性核酸片段检测分析.结果 从121份鼠标本和105组蜱标本中检出阳性结果 14份.鼠标本中检出伯氏疏螺旋体5S～23S rDNA间隔区片段1份和埃立克体(无形体)16SrDNA 5'端片段2份.蜱标本中检出阳性11份,包括伯氏疏螺旋体5S～23S rDNA间隔区片段3份和斑点热群立克次体外膜蛋白OmpA基因5'端片段8份.其中1组长角血蜱成虫标本为伯氏疏螺旋体和斑点热群立克次体复合感染,5S～23S rRNA基因间隔区和ompA基因片段均阳性,分别与伯氏疏螺旋体法雷氏基因型和马赛立克次体株等关系较近.结论 在同一组长角血蜱成虫中同时检出莱姆病疏螺旋体和斑点热群立克次体复合感染.     

辽吉两省东部山区野鼠中蜱媒病原立克次体感染的调查研究

目的了解东北地区辽吉两省东部山区啮齿动物的几种重要蜱媒病原体感染及分布情况。方法采用聚合酶链式反应(PCR)和间接免疫荧光(IFA)对从辽宁省宽甸和吉林省集安林区捕获的野鼠进行病原体DNA检测和血清抗体调查。结果捕获鼠132只,黑线姬鼠为该地区优势鼠种。PCR检测鼠脾标本132份,无形体、埃立克体及新埃立克体阳性率分别为6.06%、14.39%和3.79%,埃立克体阳性率明显高于无形体和新埃立克体(χ~2=11.083 1,P=0.003 9)。IFA检测鼠血清75份,无形体及埃立克体阳性率分别为8.00%和13.33%,差异无统计学意义(χ~2=0.629 2,P=0.427 5)。鼠中存在几种蜱媒病原体的复合感染(1.52%～5.33%)。结论我国东北地区东部山区啮齿动物中3种立克次体感染普遍,埃立克体感染较严重,提示可能存在多种立克次体病的自然疫源地。     

浙江省鼠形动物蜱源立克次体感染状况调查

目的了解浙江省不同类型地理环境中鼠形动物蜱源立克次体的感染状况。方法 2009—2011年在安吉县、金东区和天台县用夹夜法捕获鼠形动物,进行分类鉴定、无菌采集肝脾标本,并采用巢式PCR方法检测无形体属与埃立克体属16SrRNA以及立克次体属（包括斑疹伤寒群和斑点热群）与东方体属热休克蛋白基因groEL。结果 3个调查点共捕获鼠形动物14种851头,社鼠（30.32%）、黑线姬鼠（18.80%）和青毛鼠（11.75%）为主要优势种,其中金东区、安吉县和天台县的优势鼠种分别为社鼠（39.20%）、青毛鼠（32.05%）和黑线姬鼠（59.57%）。562份肝脾标本中检出立克次体48份,阳性检出率为8.54%;其中无形体属占3.38%,斑疹伤寒群占1.78%,恙虫病东方体属占1.78%,埃立克体属占1.07%,斑点热群占0.53%。金东区和安吉县无形体属检出率较高为4.76%和4.27%,斑点热群仅在天台县检出。社鼠的立克次体阳性检出率最高为14.97%。同一鼠形动物可存在多种立克次体混合感染。结论浙江省不同类型地理环境鼠形动物中广泛存在立克次体感染,不同地理位罝和不同鼠形动物的蜱源立克次体检出率不同。     

湖北省随州市蜱携带埃立克体的核酸检测

埃立克体是一类严格细胞内寄生的革兰阴性菌,属无形体科(richettsiaceae),埃立克体属[1].主要寄生在单核细胞、巨噬细胞内,引起人或动物感染埃立克体病[2],蜱是其传播媒介[1].     

浙江省在鼠形动物中检测到伯氏疏螺旋体

目的了解鼠形动物中自然感染伯氏疏螺旋体的状况。方法用巢式聚合酶链反应扩增鼠中的伯氏疏螺旋体5S--23SrRNA间隔区片段，对阳性产物进行测序。结果在浙江省金华市金东区捕获鼠形动物128只，在黄毛鼠、姬鼠、臭鼬鼯中共检测到阳性12份，阳性率分别为9．68％、14．28％和25．00％，并对其中2份进行测序分析，与伯氏疏螺旋体的法雷斯疏螺旋体相同，基因区间序列号分别为AB091447BvalaiOS115和DQ188933BvalaiQX13P25，相似率达100％。结论初步认为浙江省存在伯氏疏螺旋体病原。黄毛鼠、姬鼠、臭鼠句鼯可能为伯氏疏螺旋体的法雷斯疏螺旋体宿主，尚需进一步调查。     

福建省武夷山林区人群人粒细胞无形体血清流行病学调查

人粒细胞无形体引起的人粒细胞无形体病(humangranulocytic anaplasmosis)是发现于20世纪90年代的一种新发传染病.按最新的分类标准[1],无形体属立克次体目,无形体科,变形菌纲,α亚群,人粒细胞无形体与以前命名的马埃立克体和嗜吞噬埃立克体同属无形体科(Anaplasmataceae)无形体属(Anaplasma)中的一个种,即嗜粒细胞无形体(Anaplasma phagocytophila),其主要寄生在人粒细胞的胞质空泡内.     

埃立克体和埃立克体病

埃立克体属(Ehrlichia)细菌属于α-变形菌纲(α-Proteobacteria)立克次体目(Rickettsiales)的无形体科(Anaplasmataceae).埃立克体在自然界中借助节肢动物媒介和脊椎动物宿主而存在,能引起人或动物埃立克体病.1925年世界首次发现引起牛羊等反刍动物水胸病(heartwater disease)的病原体为立克次体类病原体,并命名为反刍动物立克次体(Rickettsia ruminantium)^[1].1991年首次报道埃立克体能对人致病^[2].在过去的30多年中,随着PCR检测方法的完善与测序技术的发展,新的埃立克体在世界各地不断被发现,更多的国家与地区证实了埃立克体及埃立克体病的存在.随着社会生态环境的改变,人类与节肢动物及野生动物的接触增加,由新埃立克体引起的新发传染病时有报道^[3].为此本文对近年来国内外在埃立克体病原学、流行病学、致病性方面的研究进展综述如下.     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

骨钙素与儿童生长发育

骨钙素是成骨细胞分泌的骨蛋白 ,骨钙素水平与成骨细胞活性成正相关 ,是一项很好的反映骨形成与骨转化的生化指标。小儿骨生长发育有自身特点 ,骨钙素水平的改变类似儿童身高生长曲线 ,可以很好地应用于评价儿童生长发育及监测生长障碍患儿对治疗的反应     

Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.